scholarly journals Correlation between D-dimer and computed tomography severity score in middle aged young adults with COVID-19 pneumonia: a retrospective study

2021 ◽  
Author(s):  
Deepak Kumar A. ◽  
Sachin N. Solanke
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Severity Score ◽  
Rt Pcr ◽  
Wuhan City ◽  
Medical College ◽  
Coagulation Tests ◽  
The Mean ◽  
D Dimer ◽  
Time Point

Background: An unknown pneumonia broke out in Wuhan City in December 2019 and it was confirmed as an acute respiratory infectious disease caused by Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, formerly known as 2019-nCoV). Consumption coagulopathy, which should be obviated in order to decrease mortality, arises in disseminated intravascular coagulation with a decrease in fibrinogen and an increase in D-dimer levels. However, studies on the predictive and prognostic values of coagulation parameters in the setting of patients with COVID-19 are still limited. The objective of this retrospective study was to investigate the correlation of D-dimer and computed tomography severity score in patients with COVID-19 pneumonia.Methods: The present retrospective study was conducted among 108 subjects reported COVID RT-PCR positive admitted during the study period i.e.; January-August 2021 in the department of medicine of Rural Medical College, Loni. Pneumonia was confirmed by Computed tomography (CT) examination and coagulation test completed within 12 hr after admission were enrolled. Coagulation tests, which Fibrinogen (Fib) and D-dimer were performed. CT score was categorized into mild (0-7), moderate (8-16) and advanced grade (17-25 points).Results: The mean age of male and female was 38.52±5.34 and 35.67±3.22 years respectively, with an overall age of 37.79±4.58 years. Mean D-dimer level was 0.54±0.09, 0.91±0.22 and 1.96±0.47 mcg/ml among subjects having mild, moderate and severe CT score respectively. According to multivariate analysis, higher D-dimer (OR:3.61, p<0.01) was significantly associated with CT severity score.Conclusions: Study concluded that the D-dimer level's time point was matched to the time of CT scan, we have reasons to correlate that the D-dimer level may predict the severity of inflammation prior to coagulopathy/thrombosis.

scholarly journals Different chest CT scoring systems in patients with COVID-19: could baseline CT be a helpful tool in predicting survival in patients with matched ages and co-morbid conditions?

2021 ◽  
pp. 028418512110063
Author(s):  
Okan Dilek ◽  
Emin Demirel ◽  
Hüseyin Akkaya ◽  
Mehmet Cenk Belibagli ◽  
Gokhan Soker ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Severity Score ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Survival Prediction ◽  
Success Rates ◽  
Survival Times ◽  
The Mean ◽  
Early Decision ◽  
Age Range

Background Computed tomography (CT) gives an idea about the prognosis in patients with COVID-19 lung infiltration. Purpose To evaluate the success rates of various scoring methods utilized in order to predict survival periods, on the basis of the imaging findings of COVID-19. Another purpose, on the other hand, was to evaluate the agreements among the evaluating radiologists. Material and Methods A total of 100 cases of known COVID-19 pneumonia, of which 50 were deceased and 50 were living, were included in the study. Pre-existing scoring systems, which were the Total Severity Score (TSS), Chest Computed Tomography Severity Score (CT-SS), and Total CT Score, were utilized, together with the Early Decision Severity Score (ED-SS), which was developed by our team, to evaluate the initial lung CT scans of the patients obtained at their initial admission to the hospital. The scans were evaluated retrospectively by two radiologists. Area under the curve (AUC) values were acquired for each scoring system, according to their performances in predicting survival times. Results The mean age of the patients was 61 ± 14.85 years (age range = 18–87 years). There was no difference in co-morbidities between the living and deceased patients. The survival predicted AUC values of ED-SS, CT-SS, TSS, and Total CT Score systems were 0.876, 0.823, 0.753, and 0.744, respectively. Conclusion Algorithms based on lung infiltration patterns of COVID-19 may be utilized for both survival prediction and therapy planning.

Kirschner Pin Migration Associated with the Sliding Genioplasty

1993 ◽  
Vol 10 (1) ◽  
pp. 15-19
Author(s):  
David J. Gingrass
Keyword(s):  
Retrospective Study ◽  
Bone Plates ◽  
Surgical Indications ◽  
Common Procedure ◽  
Vertical Movements ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Fixation Techniques ◽  
The Mean

The sliding genioplasty for cosmetic augmentation of microgenia is a common procedure performed by maxillofacial and cosmetic surgeons. There are multiple designs for this osteotomy, and multiple fixation techniques proposed, among which include wires, screws, bone plates, and pins. Likewise, there are many advantages and disadvantages to each of the designs and the fixation techniques that will be utilized according to the surgical indications and the surgeon's preference. A techique used at the Medical College of Wisconsin in Milwaukee involves fixation of the osteotomy segments with Kirschner pins placed at multiple divergent angles. This technique allows for placement of the free segments in virtually any location, and provides for a type of rigid stabilization, particularly in large anterior and vertical movements. One criticism that has been suggested with the use of Kirschner pins is the possibility of migration. This retrospective study evaluates 13 patients who underwent augmentation genioplasty, rigidly fixated with Kirschner pins. Twenty-eight total Kirschner pins were placed, with one being removed. The mean postoperative follow-up was 32 months, and the average number of pins placed was 2.15 per patient. It would appear then, from this study, that migration of Kirschner pins when used with the sliding genioplasty, is not a significant postoperative concern.

Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes

2016 ◽  
Vol 52 (6) ◽  
pp. 371-377 ◽  
Author(s):  
Ryota Iwasaki ◽  
Takashi Mori ◽  
Yusuke Ito ◽  
Mifumi Kawabe ◽  
Mami Murakmi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Body Weight ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Prediction Interval ◽  
Short Axis ◽  
Computed Tomographic ◽  
The Mean

ABSTRACT The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

scholarly journals Biochemical parameters of mild, moderate & severe COVID-19 patients

2021 ◽  
Vol 11 (2) ◽  
pp. 031-039
Author(s):  
Khushbun Nahar Layla ◽  
Shahanara Yeasmin ◽  
Sharif Ahmed Khan ◽  
Masba Uddin Chowdhury ◽  
Afrina Binte Azad ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Serum Albumin ◽  
Prothrombin Time ◽  
Serum Ferritin ◽  
Biochemical Parameters ◽  
Rt Pcr ◽  
College Hospital ◽  
Positive Correlation ◽  
Medical College ◽  
D Dimer

Background and objectives: Coronavirus disease 2019 (COVID-19) is affecting millions of people world-wide. It is caused by the severe acute respiratory syndrome corona virus 2(SARS-CoV-2). The laboratory findings are very important to assess the progress of the disease. The present study is aimed to discuss the biochemical parameters among mild, moderate and severe COVID-19 patients. Materials and methods: A cross sectional study were conducted in the Department of Physiology, Dhaka Medical College, Dhaka from January 2020 to December 2020. After obtaining ethical clearance, a total of 100 real time-polymerase chain reaction (RT-PCR) COVID-19 positive patients were selected from Dhaka Medical College Hospital. With all aseptic precautions, 10 ml of venous blood was collected from ante-cubital vein. D-dimer, prothrombin time, C-reactive protein (CRP), lactate dehydrogenase (LDH), serum ferritin, random blood glucose (RBG), serum creatinine, serum glutamic-pyruvic-transaminase (SGPT) and serum albumin measured in the Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. CRP was measured by Immunoturbidimetric method, serum ferritin was estimated by Chemiluminescent microparticle immunoassay. STA-neoplastine CI plus used with STA-R analyzer was used for determination of prothrombin time. D-dimer was estimated by Immunofluorescence Assay method. Serum LDH is measured by Dimention clinical chemistry system, serum albumin is measured by bromocresol purple dye binding method, serum creatinine is measured by Jaffe alkaline picrate method and serum SGPT is measured by colourmetric (IFCC 1980) method and RBG is measured by enzymatic colorimetric method (GOD-PAP). Data were recorded in a pre-designed structured data collection form. For statistical analysis, ANOVA followed by Bonferroni test, Chi square test, Spearman’s rho correlation coefficient test was performed as applicable using SPSS for windows version 25.0. Results: By analyzing biochemical parameters of mild, moderate and severe RT-PCR positive 100 COVID-19 patients revealed evaluation of biochemical parameters shows severity of the disease was significantly associated with CRP, SGPT, S. Creatinine, LDH, Ferritin, D-dimer & Prothrombin time. No significant association was found with RBG & S. Albumin. Bonferroni correction following ANOVA was performed to compare between each group. Spearman’s correlation reveals statistically significant strong positive correlation with CRP, Ferritin & D-dimer, moderate positive correlation with S. Creatinine, LDH and mild positive correlation with SGPT & Prothrombin time. Conclusion: This study showed D-dimer, prothrombin time, CRP, LDH, ferritin, serum creatinine and SGPT are significantly associated with the severity of the illness that is higher in severe group in comparison to mild and moderate groups. So, comprehensive analysis of the biochemical parameters will be very helpful for early identification & better management of severe disease.

scholarly journals Dynamics of ORF1ab and N Gene among hospitalized COVID-19 positive cohorts: A hospital based retrospective study

2020 ◽  
Author(s):  
Pojul Loying ◽  
Vaishali Sarma ◽  
Suranjana C. Hazarika ◽  
Monjuri Kataki ◽  
Dina Raja ◽  
...  
Keyword(s):  
Retrospective Study ◽  
N Gene ◽  
Time Interval ◽  
Rt Pcr ◽  
The Mean ◽  
Exhaustive Study ◽  
And Gender ◽  
Mean Differences ◽  
And Control ◽  
Relationship Of

1.AbstractObjectiveThe present study hospital based retrospective study aimed at investigating the dynamics of ORF1ab and N gene from hospitalized COVID-19 positive cohorts considering the Ct values of both genes.Study design and MethodologyRetrospective analyses of Ct values were done from 115 hospitalized COVID-19 positive patients in different time interval. Patients were admitted to the hospital either by RAT or/and RT-PCR and first RT-PCR testing were made after 9 days of incubation followed by testing in every 3 days of interval till negative, subsequently release of the patients.ResultsWe have looked into the dynamics of ORF1ab and N gene and found that N gene require longer duration of days with 12.68 (S.D.±3.24) to become negative than ORF1ab with 12.09 (S.D.±2.88) days and it differs significantly (p=0.012; p<0.05). The persistent of N gene found in 46 patients out of 115 (39.65%) to the succeeding reading after 3 days. We have also looked into the mean differences in the between N and ORF1ab genes every readings separately and found that there were no significant differences between the mean Ct value of ORF1ab and N gene except in the day 3 (p=0.015; p<0.05). Further, we have looked into the relationship of age and gender of patients with the duration of positivity; however we did not find any significant role.ConclusionIn COVID-19 hospital positive cohorts, the persistent of positivity of N gene is significantly for more duration than ORF1ab. As the SARS-CoV-2 is a new virus and study on it is evolving, so, exhaustive study is required on the dynamic of N gene positivity persistent in relation to the other pathophysiological parameters for the management and control of COVID-19.

CORRELATION BETWEEN CT CHEST SEVERITY SCORE AND CLINICAL PARAMETERS AND BIOCHEMICAL MARKERS IN COVID 19 PATIENTS

2021 ◽  
pp. 25-28
Author(s):  
Pramodh Kumar ◽  
Konduru Aneesha ◽  
Ch. Radhika ◽  
Elaya Kumar ◽  
R. Srinivasan
Keyword(s):  
Severity Score ◽  
Biochemical Markers ◽  
Tamil Nadu ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Parameters ◽  
Care Hospital ◽  
Rt Pcr ◽  
The Relationship ◽  
D Dimer

AIM: To correlate between CT chest severity score in COVID 19 patients with Clinical [SpO2, RR, PaO2/FiO2] and Biochemical parameters [NLR ratio, CRP, D- Dimer values]. METHODS: A Retrospective, observational study was conducted in a tertiary care hospital in Kanchipuram, Tamil Nadu. 110 patients were admitted to the hospital with COVID 19 [RT PCR swab for COVID 19 positive and radiologically positive] between March 2021 to June 2021. The patient was clinically, radiologically, and biochemically evaluated. CT chest severity score was used to differentiate the patients into mild, moderate, and severe groups. The relationship between CT Severity score and Clinical parameters such as SpO2, RR, PaO2/FiO2 and Biochemical markers [ NLR ratio, CRP, D-Dimer] were studied. RESULTS: CT chest severity score was found to be positively correlated with decreased SpO2 levels, decreased PaO2/ FiO2, increased RR and elevated NLR ratio, D Dimer and CRP levels(P < 0.001). CONCLUSION: The 25 CT Severity score scores well with the Clinical parameters and biochemical markers. Our data suggest that CT Chest Severity Score correlates well with clinical parameters and biochemical markers.

scholarly journals Pulmonary infection caused by Mycobacterium kansasii: findings on computed tomography of the chest

2016 ◽  
Vol 49 (4) ◽  
pp. 209-213 ◽  
Author(s):  
Roberto Mogami ◽  
Telma Goldenberg ◽  
Patricia Gomes Cytrangulo de Marca ◽  
Fernanda Carvalho de Queiroz Mello ◽  
Agnaldo José Lopes
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Pulmonary Infection ◽  
Airway Disease ◽  
Architectural Distortion ◽  
Mycobacterium Kansasii ◽  
Computed Tomography Scans ◽  
Large Airways ◽  
The Mean

Abstract Objective: To describe the main tomography findings in patients diagnosed with pulmonary infection caused by Mycobacterium kansasii. Materials and Methods: Retrospective study of computed tomography scans of 19 patients with pulmonary infection by M. kansasii. Results: Of the 19 patients evaluated, 10 (52.6%) were male and 9 (47.4%) were female. The mean age of the patients was 58 years (range, 33-76 years). Computed tomography findings were as follows: architectural distortion, in 17 patients (89.5%); reticular opacities and bronchiectasis, in 16 (84.2%); cavities, in 14 (73.7%); centrilobular nodules, in 13 (68.4%); small consolidations, in 10 (52.6%); atelectasis and large consolidations, in 9 (47.4%); subpleural blebs and emphysema, in 6 (31.6%); and adenopathy, in 1 (5.3%). Conclusion: There was a predominance of cavities, as well as of involvement of the small and large airways. The airway disease was characterized by bronchiectasis and bronchiolitis presenting as centrilobular nodules.

scholarly journals Evaluation of Hepatic, Renal and Cardiac Diagnostic Markers in Patients With Severe COVID-19

2021 ◽  
Author(s):  
Sara Mobarak ◽  
Asma Mohammadi ◽  
Atefeh Zahedi ◽  
Saeed Jelvay ◽  
Fatemeh Maghsoudi ◽  
...  
Keyword(s):  
Diagnostic Markers ◽  
Direct Bilirubin ◽  
Inclusion Criteria ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Infectious Disease Physician ◽  
The Mean ◽  
And Gender ◽  
Age Range ◽  
D Dimer

SARS-CoV-2 that causes Coronavirus disease 2019 (COVID-19) was first known in Wuhan, China, in December 2019. The aim of this study was to evaluate the level of common hepatic, renal, and cardiac diagnostic markers in hospitals in patients with severe COVID 19. In this study, 259 patients with symptoms of severe COVID-19 and a positive RT-PCR assay of nasopharyngeal samples were enrolled. Inclusion criteria are positive for COVID-19 patients at the diagnosis of an infectious disease physician. Diagnostic markers of liver, kidney, and heart were evaluated by age and gender. In this study, 48.3% of patients severe with COVID-19 were male, and 51.7% were female. The mean of markers such as LDH, Direct Bilirubin, SGOT, SGPT, D-dimer was higher than normal, which was observed in men more than women. The mean of CK-MB also was higher than normal, which was observed in women more than men. The highest mean of markers was seen in the older ages. The mean of BUN was observed in the age range of 55-64 years and above 65 years above normal. But the mean of CPK, creatinine, potassium and alkaline phosphatase were normal. The results of the present study showed an increase in the level of some of the most important diagnostic markers of hepatic, renal, and cardiac in patients with COVID 19. This increase was greater in some markers, including SGOT, SGPT, Direct bilirubin, LDH, D-dimer, in men than in women, and more in older patients.

scholarly journals Utility of Neutrophil-Lymphocyte Ratio (NLR) as an Indicator of Disease Severity and Prognostic Marker among Patients with Covid-19 Infection in a Tertiary Care Centre in Bangalore – A Retrospective Study

2021 ◽  
Vol 8 (16) ◽  
pp. 1020-1024
Author(s):  
Ashwin Kulkarni ◽  
Divya Prabhu ◽  
Likitesh A.B. ◽  
Anil Kumar T ◽  
Varun Vinayak P. Rao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Resolution ◽  
Disease Severity ◽  
Severity Score ◽  
Computerised Tomography ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Mild Disease ◽  
Markers Of Inflammation ◽  
D Dimer

BACKGROUND The infection caused due to novel coronavirus 2 can cause wide spectrum of disease from asymptomatic mild disease to life threatening disease. The widespread inflammation is most likely the cause of the adverse outcomes. There are numerous markers of the inflammation which are used to identify the severity and prognosis of the disease. Neutrophil lymphocyte ratio (NLR) is one such marker which is easily available and feasible in all the hospital settings. This study intended to evaluate the NLR as a marker of disease severity and prognosis, in those with Covid-19. METHODS This was a retrospective study to determine the utility of NLR as a marker of severity and prognosis among patients with Covid disease. Medical records of 60 patients admitted with mild to moderate Covid-19 disease were reviewed and relevant data was retrieved. The NLR at admission and 72 hours later was noted. High resolution computerised tomography was done and computerised tomography severity score (CT-SS) was calculated. The outcomes of these patients were noted. RESULTS Mean NLR at admission in mild disease was 5.6 and in moderate disease was 9.2. This difference was found to be statistically significant. It was also seen that NLR had a positive co-relation with CT severity score, duration of hospital stay, Creactive protein (CRP) and D-dimer. For predicting mortality, NLR with cut off of 6.6 had a sensitivity of 100 % and a specificity of 66.07 %. CRP with cut off of 6.8 had sensitivity of 100 %, specificity of 76.79 %. D-dimer with cut off of 1.6 had specificity of 78.58 %. For predicting severity, NLR with cut off of 6.6 had sensitivity of 75 % and specificity of 80 %. CRP with cut off of 7.9 had sensitivity of 65 % and specificity of 100 %. D-dimer with cut off of 1.3, had sensitivity of 90 % and specificity of 97.5 %. CONCLUSIONS The study shows that neutrophil–lymphocyte ratio is a good indicator of disease severity and has prognostic significance in Covid-19. There is a positive correlation with high-resolution computed tomography (HRCT) chest score and other markers of inflammation among patients with Covid-19. Serial monitoring of NLR can be utilised as a surrogate to HRCT chest to determine disease severity whenever the latter is not available. This can ensure early intervention and help prevent mortality. KEYWORDS Neutrophil-Lymphocyte Ratio, Severity of Covid

scholarly journals CORRELATION BETWEEN CHEST COMPUTED TOMOGRAPHY AND LUNG ULTRASONOGRAPHY IN PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19)

2020 ◽  
Author(s):  
Yale Tung-Chen ◽  
Milagros Martí de Gracia ◽  
Aurea Díez-Tascón ◽  
Sergio Agudo-Fernández ◽  
Rodrigo Alonso-González ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Ct Scan ◽  
Severity Score ◽  
Chest Ct ◽  
Lung Ultrasonography ◽  
Rt Pcr ◽  
Lung Abnormalities ◽  
Missed Diagnosis ◽  
Similar Accuracy

ABSTRACTINTRODUCTIONThere is growing evidence regarding the imaging findings of Coronavirus Disease 2019 (COVID-19), in chest X-ray and Computed Tomography scan (CT). At this moment, the role of Lung Ultrasonography (LUS) has yet to be explored.OBJECTIVESThe main purpose of this study is to evaluate the correlation between LUS findings and chest CT in confirmed (positive RT-PCR) or clinically highly suspicious (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) of COVID-19 patients.METHODSProspective study carried out in the emergency department (ED) of confirmed or clinically highly suspicious COVID-19 patients who were subjected to a chest CT and concurrent LUS exam. An experienced ED physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). Compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations.RESULTSBetween March and April 2020, fifty-one patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiological signs compatible with COVID-19 were present in thirty-seven patients (72.5%) on CT scan and forty patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (OR: 13.3, 95%CI: 4.539.6, p<0.001) with a sensitivity of 100.0% and a specificity of 78.6%, positive predictive value of 92.5% and negative of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared to CT in our cohort. The LUS Score had a good correlation with CT total severity score (ICC 0.803, 95% CI 0.60-0.90, p<0.001).CONCLUSIONLUS presents similar accuracy compared to chest CT to detect lung abnormalities in COVID-19 patients.Summary StatementLUS presents similar accuracy compared to chest CT to detect lung abnormalities in COVID-19 patients.Key Results-Common LUS findings mirror those previously described for CT: bilateral, peripheral, consolidation and/or ground glass opacities.-LUS findings correlated with CT scan with a sensitivity of 100.0% and a specificity of 78.6%, positive predictive value of 92.5% and negative of 100.0%. The Lung score had a good correlation with CT total severity score (ICC 0.803, 95% CI 0.601-0.903, p < 0.001).-There were no missed diagnosis of COVID-19 with LUS compared to CT in our cohort.

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